CAJ | 학술논문

目的探讨辛伐他汀在脊髓缺血再灌注损伤中的保护作用及其可能的作用机制.方法 24只健康成年西藏小型猪,雌雄不拘,体质量20 ～ 30 kg.随机分为假手术组、对照组和实验组,每组8只.胸主动脉阻断法建立脊髓缺血再灌注损伤模型,分离副半奇静脉,远心端结扎,近心端插管.术中记录心电图、近心端血压、远心端血压、心率、鼻咽温.缺血过程中,对照组副半奇静脉逆灌乳酸林格钠液1 000 ml(860 ml/h),实验组副半奇静脉逆灌辛伐他汀溶液1 000 ml (0.25 mg/kg,860 ml/h).术后继续饲养,实验组连续30天口服辛伐他汀片剂80 mg/天.术后30天,收集L2～L5及骶段脊髓标本及血清,行组织形态学、电镜及Elisa检测.结果与对照组相比,实验组核溶解程度较轻,神经元结构相对完整,存活数量较多,白细胞介素-1(IL-1)表达降低,脑源性神经营养因子(BDNF)和胶质细胞源神经营养因子(GDNF)表达增加.结论术中和术后持续使用辛伐他汀可明显促进脊髓缺血再灌注损伤后的神经元恢复,该神经保护作用可能与降低炎性反应,增加BDNF、GDNF表达有关.
목적 탐토신벌타정재척수결혈재관주손상중적보호작용급기가능적작용궤제.방법 24지건강성년서장소형저,자웅불구,체질량20 ～ 30 kg.수궤분위가수술조、대조조화실험조,매조8지.흉주동맥조단법건립척수결혈재관주손상모형,분리부반기정맥,원심단결찰,근심단삽관.술중기록심전도、근심단혈압、원심단혈압、심솔、비인온.결혈과정중,대조조부반기정맥역관유산림격납액1 000 ml(860 ml/h),실험조부반기정맥역관신벌타정용액1 000 ml (0.25 mg/kg,860 ml/h).술후계속사양,실험조련속30천구복신벌타정편제80 mg/천.술후30천,수집L2～L5급저단척수표본급혈청,행조직형태학、전경급Elisa검측.결과 여대조조상비,실험조핵용해정도교경,신경원결구상대완정,존활수량교다,백세포개소-1(IL-1)표체강저,뇌원성신경영양인자(BDNF)화효질세포원신경영양인자(GDNF)표체증가.결론 술중화술후지속사용신벌타정가명현촉진척수결혈재관주손상후적신경원회복,해신경보호작용가능여강저염성반응,증가BDNF、GDNF표체유관.
Objective Inspired by the simvastatin' s brain protective effect,we seek to investigate its protective effect and mechanism of the spinal cord ischemia/reperfusion injury.Methods 24 healthy adult tibet mini-pigs of either sex,weighted 20-30 kg,were randomly divided into 3 groups,8 pigs in each group.Group A,Sham operation group.Group B,Control group,i.e.the simple Ischemia/Reperfusion group.Group C,simvastatin experimental group.Creating the models of spinal cord Ischemia/Reperfusion by thoracic aorta occlusion (70 min).Isolating the accessory hemiazygos vein and ligating the distal end.1000 ml lactated ringer solution were pumped into the vein and the rate is 860 ml/h and pumping time 70 minutes.Proximal blood pressure,distal blood pressure,heart rate and the nasopharyngeal temperature were recorded every 10 minutes during the operation.After the operation,pigs were kept free access to food and water.Pigs of the simvastatin experimental group were fed with simvastatin tablets 80 mg/day,orally for 30 days.Recording the motor function score at 6,24,48 h after reperfusion (see Taylor motor function scoring system).All 8 pigs of each group were killed at 30 days after reperfusion and take the L2-L5 and sacral spinal cord as quickly as possible to observe the express changes of IL-1、BDNF and GDNF applying immunochemistry,electron microscope and Elisa method.Results In the simvastatin experimental group,the 24,48 h motor function scores were significantly higher than that in the control group (P ＜ 0.05).Compared with the control group,higher express changes of BDNF and GDNF and lower express of IL-1 can be found in the experimental group.Conclusion Simvastatin can significantly improve the neurological function recovery of spinal cord ischemia reperfusion injury.And it is related to higher express of BDNF GDNF and lower express of IL-1.